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PubMed1995

Predictors of atopy in newborn babies.

The capacity of laboratory tests and clinical signs to predict allergic manifestations up to 18 months of age was assessed in 129 newborn babies, most of whom had family members with atopic disease. The parameters assessed included family history; skin dryness; erythema toxicum; skin reactivity to histamine and IgE levels; eosinophil counts; and peripheral white blood cell, leukocyte differential, and platelet counts in cord blood (CB). Erythema toxicum and white blood cell and platelet counts were of no value as predictors of allergy. The sensitivity of family history, skin dryness, and sensitivity to histamine, as well as IgE levels and eosinophil counts, varied 25-79% and the specificity 40-74%. The efficiency was never higher than 58%. Logistic regression, applied in order to evaluate the joint predictive power of the five parameters, showed a P value of < 0.001. The estimated probability for atopy before 18 months of age was 0.33 for neonates with normal skin texture, a CB IgE of less than 0.5 kU/l, and a history of fewer than two family members with atopy. The probability increased to 0.89 for babies with a dry skin, a history of two or more atopic family members, and a CB IgE of > or = 0.5 kU/l. In conclusion, not one parameter nor any combination of them seems suitable for general screening. However, a combination of family history and CB IgE and skin assessment may be used to identify babies at high risk of allergy for participation in prevention studies.

Child Development↗
PubMed1998

Prevalence of occupational asthma among automobile and furniture painters in the center of Eskisehir (Turkey): the effects of atopy and smoking habits on occupational asthma.

BACKGROUND: Occupational asthma (OA) is a respiratory disorder characterized by airway hyperreactivity caused by agents present in the workplace. For determination of the prevalence of OA among car and furniture painters exposed to isocyanate in the center of Eskisehir, Turkey, a clinical and epidemiologic prospective study in three phases was done, incorporating 312 (89.4%) of the painters. METHODS: Of these subjects, 190 (61%) were furniture painters and 122 (39%) automobile painters. In the first phase of the study, a modified questionnaire and pulmonary function test (PFT) were done. During the second phase, peak expiratory flow rate (PEFR) was monitored in 52 subjects whose complaints were confirmed and who agreed to a month of such monitoring. In the third phase, nonspecific bronchial provocation tests (NSBPT) with histamine were done on 23 of the PEFR-monitored workers. RESULTS: Finally, through questionnaire, typical history, PFT, PEFR monitoring, and NSBPT, 30 workers (9.6%) were diagnosed as having OA. Smoking habits and atopy in the OA-diagnosed workers were found to be statistically significantly high in comparison to the other workers. CONCLUSIONS: It was concluded that OA is a common disorder among automobile and furniture painters, and smoking habits and atopy were seen to have a significant effect on OA occurrence.

Adolescent↗
PubMed2006

The PASTURE project: EU support for the improvement of knowledge about risk factors and preventive factors for atopy in Europe.

Since January 2002, the European Commission is funding a large project, 'Protection against Allergy--Study in Rural Environments' (PASTURE; contract no. QLK4-2001-00250), under the Fifth Framework Program in the field of epidemiology of allergic diseases. The aim of this paper was to describe the background and design as well as the aims of the project. Asthma and allergic disorders are a major public health problem in many Western countries. The aetiology of asthma and allergic disease remains poorly understood despite considerable research. Epidemiology has the potential to add greatly to the understanding by elucidating the risk factors for asthma and allergic disease and thereby suggesting productive avenues for research into causation and prevention. Several risk factors for the development of asthma and atopic disease in children such as passive smoke exposure during pregnancy and infancy, low birth weight or high body mass index later in life have been described. Furthermore, there is consistent evidence that the prevalence of atopy increases with higher socio-economic status. Levels of air pollution such as ozone, NO2, SO2 and particles are likely to provoke acute exacerbations of pre-existent respiratory disease. Their role in the inception of asthma and allergies remains to be clarified. Allergen exposure has been linked to the development of atopic sensitization to that particular allergen in children as well as in adults with occupational exposures. Exposure to house dust mite or cat allergen is, however, unlikely to contribute to the development of childhood asthma. In turn, pet keeping in the first year of life, particularly, dog keeping, has been inversely related to the development of wheeze and atopic illnesses. Several prospective birth cohort studies found a decreased prevalence of atopic disease in children having daily contact to pets, in particular to cats and dogs, during early infancy. The protective effect might be attributable to allergen or other exposures associated with pet ownership, but may also in part be because of the removal of pets in families with sensitized or symptomatic children or in families with a positive history for atopy at the time the child was born.

Cytokines↗
PubMed1993

Usefulness of neonatal eosinophil counts as a marker of atopy?

Eosinophil count (EC) were obtained from 312 newborns with and 172 without family history of atopy (FHA). The EC were higher in infants with than without FHA. Elevated EC were recorded in babies of parietaria sensitive mothers born in the spring, as compared to other seasons. The predictive value of EC with regard to development of atopic diseases up to 18 months of age was prospectively studied in 103 newborns with FHA. Using 5 x 10(8) cells/l as cut-off level the predictive allergy value was 41%. Elevated EC appears to be a marker of atopy in newborns.

Biomarkers↗
PubMed1996

Mite allergy, clinical atopy, and restriction by HLA class II immune response genes.

From a community-based study cohort of 1812 elementary schoolchildren we selected 129 unrelated participants to investigate the relevance of HLA-class II molecules (DPB, DQB, and DRB) to the regulation of immune response to the mite allergen Der p 1 and to clinical atopic disorders. On the basis of skin prick test results validated by measurement of specific IgE, individuals were selected and divided into three groups: group I (n = 20), controls without detectable specific IgE to common inhalant allergens; group II (n = 22), children sensitized only to non-mite allergens; group III (n = 85), children sensitized to Der p 1. Clinical history of asthma, eczema, and hay fever was ascertained using standardized questionnaires. In total, 43 different HLA class II alleles (DPB, n = 19; DQB, n = 14; and DRB, n = 10) were determined by sequence-specific oligonucleotide typing with PCR-amplified DNA. We were not able to demonstrate significant differences in gene frequencies of any HLA class II allele between the group of mite-sensitized children and one of the other two groups. However, the presence of certain DRB- and DPB-haplotypes (DRB *0100/*0300/*1100 and DPB *0201/*0401) was significantly associated (p < or = 0.01) with a history of asthma, hay fever, and atopy (defined as a history of asthma and/or hay fever and/or eczema). Other haplotypes, including DQB *0303/*0503, DRB *0200/ *0700, and DPB 0402 were negatively associated with a history of eczema, hay fever, and atopy (p < or = 0.01). Thus, our findings do not suggest a relevance of HLA-class II molecules to mite allergy; however, some HLA class II haplotypes appear to be predictive of the incidence of atopic disorders.

Allergens↗
PubMed1998

Bronchial hyperresponsiveness, atopy, airway inflammation, and asthma.

Airway inflammation particularly with eosinophil infiltration is an almost invariant feature of asthma, though it may not be exclusive to asthma. BHR and atopy are common phenomena in asthmatics but not invariably so. Allergen-induced late asthmatic responses can increase non-specific hyperresponsiveness and bronchial responsiveness in turn is, at least from some studies, correlated with the degree of airway inflammation. Atopy is a major risk factor for the development of asthma and its persistence from childhood into adulthood. Airway inflammation occurs very early in the natural history of asthma. No therapeutic intervention in established asthma has been shown to achieve a cure or even modify the natural history of the disease. Therefore, further studies are urgently required to identify whether strategies of early intervention to prevent the development of airway inflammation will modify the natural history of the disease.

Asthma↗
PubMed2004

Development of atopy and wheezing symptoms in relation to heredity and early pet keeping in a Swedish birth cohort.

The role of pet keeping during infancy for the development of allergy and asthma is still controversial. The objective of this population-based birth cohort study was to assess the development of atopy and different wheezing phenotypes during the first 4 yr of life in relation to heredity and early pet keeping. The cohort comprised all 1228 infants living in a Swedish county who were born over a 1-yr period. The parents replied to repeated questionnaires and 817 of the children were skin prick tested both at 1 and 4 yr. Cat keeping during the first year of life was associated with an increased risk of a positive skin prick test to cat at 1 yr of age [odds ratio (OR) 2.2, 95% confidence interval (CI) 0.9-5.6], but neither with sensitivity nor clinical symptoms of allergy at 4 yr. Dog keeping during the first year of life was associated with an increased risk of early-onset transient wheezing, but only in children with parental asthma (adjusted OR 4.3, 95% CI 1.5-12.1). In contrast, early dog keeping had an inverse association with sensitivity to pollen allergen at 4 yr (adjusted OR 0.3, 95% CI 0.1-0.9) and late-onset wheezing (adjusted OR 0.4, 95% CI 0.2-1.0). Thus, pet keeping during the first year of life was not associated with an increased risk of atopy at 4 yr, although a positive SPT to cat was more common at 1 yr. Our findings may even suggest that dog keeping during the first year of life might provide some protection from pollen allergy and late-onset wheezing and increase the risk of early-onset transient wheezing in children with heredity for asthma.

Animals↗
PubMed2005

Etiology of atopy in infancy: the KOALA Birth Cohort Study.

The aim of the KOALA Birth Cohort Study in the Netherlands is to identify factors that influence the clinical expression of atopic disease with a main focus on lifestyle (e.g., anthroposophy, vaccinations, antibiotics, dietary habits, breastfeeding and breast milk composition, intestinal microflora composition, infections during the first year of life, and gene-environment interaction). The recruitment of pregnant women started in October 2000. First, participants with 'conventional lifestyles' (n = 2343) were retrieved from an ongoing prospective cohort study (n = 7020) on pregnancy-related pelvic girdle pain. In addition, pregnant women (n = 491) with 'alternative lifestyles' with regard to child rearing practices, dietary habits (organic, vegetarian), vaccination schemes and/or use of antibiotics, were recruited through organic food shops, anthroposophic doctors and midwives, Steiner schools, and dedicated magazines. All participants were enrolled between 14 and 18 wk of gestation and completed an intake questionnaire on family history of atopy and infant care intentions. Documentation of other relevant variables started in the pregnant mother and covered the first and third trimester as well as early childhood by repeated questionnaires at 14-18, 30, and 34 wk of gestation and 3, 7, 12, and 24 months post-partum. A subgroup of participants, including both conventional and alternative lifestyles, was asked to consent to maternal blood sampling, breast milk and a faecal sample of the infant at 1 month post-partum, capillary blood at age 1 yr, venous blood and observation of manifestation of atopic dermatitis during home visits at the age of 2 yr (using the UK working party criteria and the severity scoring of atopic dermatitis index), and buccal swabs for DNA isolation from child-parent trios. From the start, ethical approval and informed consent procedures included gene-environment interaction studies. Follow-up at 3 and 7 months post-partum was completed with high response rates (respectively 90% and 88% in the conventional group, and 97% and 97% in the alternative group). The home visits at 2 yr of age will be completed in 2005. Preliminary results show that we have succeeded in recruiting a large population with various lifestyle choices with a fairly large contrast with regard to dietary habits (including organic foods, vegetarian diet), vaccination schemes and/or use of antibiotics. We have also been able to collect a large number of faecal samples (n = 1176) and capillary blood samples at age 1 yr (n = 956). Furthermore, a large proportion of the participants have consented with genetic studies. Mid 2006 we expect to report our first results on the relationship between the various exposures in early life and childhood atopy. An outline of the focus and design of the KOALA Birth Cohort Study is presented.

Anthroposophy↗
PubMed1995

Exclusion from proximal 11q of a common gene with megaphenic effect on atopy.

We have typed three markers on proximal 11q in 131 random families with three or more children studied for atopy. A summary map that includes the FCER1B candidate was constructed. Using a 2-locus disease model, we performed combined segregation and linkage analysis of three models, none of which suggested linkage. Nine marker loci on other chromosomes were also negative. In the regions swept by these 12 markers we cannot rule out a rare gene, perhaps of large effect, nor a common gene of small effect. However, a common gene of large effect is excluded. These results and alternative strategies are discussed in the perspective of inconsistent evidence for a major atopy gene.

Alleles↗
PubMed1981

Atopy and hand dermatitis in hospital wet work.

The relation of different atopic symptoms to the occurrence of hand dermatitis in employees who perform wet work in hospitals was studied. Atopy was defined as previous or present atopic dermatitis (AD), allergic rhinitis/conjunctivitis or asthma (AMS). In this population the prevalence of atopy was 32% and the frequency of past or present hand dermatitis 44%. Hand dermatitis had occurred in about 65% of persons with atopic symptoms and in 75% of those who had unusually dry, pruritic skin and of those with atopic relatives. Of the other workers only 33% had had skin problems. The presence of atopic symptoms significantly favoured the development of hand dermatitis in these occupations (p less than 0.001).

Adult↗
PubMed1984

The role of atopy in occupational dermatoses.

Hayfever was the commonest symptom of atopy among a group of 134 individuals who had been compensated for work-related skin disease in South Carolina. A history of previous eczema and a history of wool intolerance differed significantly between the group with contact dermatitis and the group with other work-related dermatoses. The rôle of atopy figured dramatically among the more serious cases, accounting for 93% of these cases resulting in job loss.

Animals↗
PubMed1989

Atopy in subjects with a history of nickel allergy but negative patch tests.

Various markers of atopy were studied in 20 subjects with a history of nickel allergy but negative patch test reactions, and compared with 2 control groups: 13 subjects with no history of nickel allergy and negative patch tests; 11 subjects with a history of nickel allergy and positive patch tests. No significant difference in the incidence of atopy was detected in the 3 groups.

Dermatitis, Atopic↗
PubMed2006

Asthma severity and atopy: how clear is the relationship?

BACKGROUND: The relationship between asthma severity and atopy is complex. Many studies have failed to show significant relationships between clinical severity or lung function and markers of atopic sensitisation. AIM: To determine whether increasing asthma severity is related to atopic sensitisation in a population of children with asthma. METHODS: A total of 400 children (7-18 years) with asthma were recruited as part of a multicentre study of the genetics of asthma. Detailed phenotypic data were collected on all participants. Associations between measures of asthma severity and atopic sensitisation were sought using multilevel models allowing variation at the individual and family level. RESULTS: Children recruited to the study had a range of asthma severities, with just over a third having mild persistent asthma. The logarithm of total serum IgE was associated with increased asthma severity score, decreased FEV1, increased airways obstruction, risk of hospital admission, and inhaled steroid use. Increasing skin prick test reactivity to a panel of seven aeroallergens was associated with increased risk of hospital admission, use of an inhaled steroid, and airways obstruction. The results remained highly significant after corrections for age, gender, and birth order. CONCLUSIONS: In children with asthma, increasing atopy is associated with increasing asthma severity. However, the relationships between asthma severity and skin prick tests, and asthma severity and total serum IgE values, appear subtly different.

Adolescent↗
PubMed1980

Atopy in parents of children dying with sudden infant death syndrome.

36 parents of infants who had died suddenly did not differ in frequency of atopic symptoms, immediate skin tests, IgE, IgE antibody, immunoglobulin G, A, and M, or yeast opsonisation, from 36 matched controls, although atopy was common (about half had atopy in both groups.

Adult↗
PubMed1989

Prevalence of atopy and range of bronchial response to methacholine in 7 and 11 year old schoolchildren.

A sample of 397 from 2503 children aged 7 and 11 years, who took part in an earlier questionnaire study of respiratory symptoms in Southampton, was chosen for methacholine bronchial provocation and allergen skin testing. Results were obtained from 330 (84%). A good level of repeatability was achieved for bronchial provocation testing giving a 95% confidence interval equivalent to 1.74 doubling concentrations. The main problem encountered with methacholine was its bitter taste in high concentrations. The proportion of children, in whom the dose of methacholine which produced a fall of 20% in the forced expiratory volume in one second (PD20 methacholine) was less than or equal to 6.4 mumol, fell from 29.1% at 7 years to 16.5% at 11 years. The prevalence of atopy increased from 26% at 7 years to 31.6% at 11 years. A highly significant association was found between bronchial responsiveness to methacholine and atopy, which was independent of symptoms or age group.

Bronchi↗
PubMed1992

Atopy, bronchial responsiveness, and symptoms in wheezy 3 year olds.

Fifty children with at least one hospital admission for acute lower airway obstruction in the first 2.5 years of life were assessed at 3 years of age to determine the relationship between atopy, bronchial responsiveness, and the pattern of their symptoms. Bronchial responsiveness was measured by assessing the effect of inhaled metacholine, using the change in transcutaneous oxygen tension (PtCO2) as an indirect measure of response. Symptom patterns were defined by the number of wheezing episodes associated with colds and the presence or absence of cough or wheeze unrelated to viral infections. Forty per cent of the children were found to be atopic by skin prick test or history. In contrast to the situation found in older children and adults, the non-atopic children had significantly greater bronchial responsiveness (lower mean concentration of methacholine causing a 20% fall in PtCO2, the PC20) than the atopic children and significantly more of them had an onset of respiratory symptoms in the first year of life. Cough and wheeze in the absence of colds was more frequently found in the atopic children as was the use of continuous medication. However, the number of reported acute episodes of wheeze associated with colds was the same in the two groups. The findings of the study suggest that in this hospital based group of children, acute wheeze associated with colds in the first three years of life is independent of the finding of atopy and that bronchial responsiveness in this age group may have a different pathogenesis from that in older subjects.

Blood Gas Monitoring, Transcutaneous↗
PubMed1981

Atopy does not predispose to RSV bronchiolitis or postbronchiolitic wheezing.

Twenty-six 8-year-old children who had had respiratory syncytial virus (RSV) bronchiolitis in infancy and their paired controls underwent skin and blood tests to assess the role of immunodeficiency and atopy in the pathogenesis of RSV bronchiolitis and the wheezing that may follow it. There was no difference between patients and controls in prevalence of atopy; positive results of prick tests to common antigens; eosinophil counts; yeast opsonisation defect; C2 deficiency; IgG, IgA, IgM, and IgE concentrations; or IgE antibody to dermatophagoides, timothy-grass pollen, and cat fur. Those of the children who had had RSV bronchiolitis and who continued to wheeze had a slightly higher mean eosinophil count and levels of IgE antibody to dermatophagoides than those who did not wheeze. Exercise-induced bronchial lability, though higher in patients than controls, did not correlate significantly with eosinophil counts or IgE concentrations. The genetic factors predisposing to RSV bronchiolitis and postbronchiolitic wheezing may differ from those predisposing to atopic asthma, though exclusive breast feeding may protect against both.

Bronchiolitis, Viral↗
PubMed1996

Investigation of an interleukin-4 promoter polymorphism for associations with asthma and atopy.

The cytokine cluster located on chromosome 5 has been shown by linkage studies to play a role in the genetic determination of circulating immunoglobulin E (IgE) levels in atopic subjects. In the study presented here, the reported chromosome 5 linkage has been investigated in two sets of subjects. The first consisted of a general population sample of 230 nuclear families (n = 1004) from Busselton, a small West Australian country town. The second group consisted of 124 unrelated atopic asthmatics and 59 unrelated non-atopic, non-asthmatic controls, all resident in the Oxfordshire Regional Health Authority area in the United Kingdom. A previously reported interleukin-4 (II-4) promoter polymorphism (-590 C-->T) was analysed in these populations by a newly designed method of specific PCR amplification and BsmFI restriction endonuclease digestion. In the Busselton population the polymorphism was shown to be weakly associated with specific IgE to house dust mite (Mann-Whitney-U test, p = 0.013) and to wheeze (MWU test, p = 0.029), but not with specific IgE to grass pollen, total serum IgE, bronchial hyperresponsiveness, eosinophil count, or asthma. In the Oxfordshire subjects there were no statistically significant associations with any measure of asthma or atopy. These data show that the -590 C-->T II-4 promoter polymorphism is only weakly associated with certain measures of asthma and atopy in some subjects. It was specifically not associated with serum IgE concentration or asthma in either of the two groups in this study.

Adolescent↗